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For the past few years, I’ve felt a primal urge to disengage from the world around me. This inner restlessness is strongest when I’m in public and forced to witness the current state of our culture and values—garbage littering the streets, people Face-timing without headphones, rampant obesity, fourteen year old girls with false eyelashes and lip injections. It’s all inner pain manifested in the physical world, fueled by a system preying on people’s vulnerabilities to make money.

Bit of a bitch for cultivating happiness, eh?

As much as I see evidence of generational cultural improvement—for example, the expansion of gay and women’s rights over the past 50 years (save for the recent Supreme Court idiocy)—the cynic in me doubts we’ll see meaningful change in our lifetime when it comes to the environment, mental health, and ethical technological application. CO2 emissions, Big Pharma, and AI aren’t going anywhere anytime soon. The speed, money, and power generated from these industries is simply too persuasive under the current system. Perhaps a shift will occur one day, but for now, it seems to me that the real game is figuring out how to thrive as an individual in a toxic environment.

Enter Johann Hari and his new-ish book, Stolen Focus: Why You Can’t Pay Attention and How To Think Deeply Again. It’s one of the may books I’ve been reading when I retreat back into my sanctuary to think about how in the hell I’m going to maintain my sanity in a world so far removed from our animal nature.

It’s also a book that sat on my shelf for a long time because I said to myself, “I just wrote and published a book. My focus is just fine.”

Except, in the months since MAY CAUSE SIDE EFFECTS came out, I’ve been a scattered mess. No queue without a scroll through Instagram. No stoplight without an email check. No evening without an iPad.

Finally, after a conversation with a client who told me how he’s been leaving his phone at home and walking to his local library just to have a long stretch of uninterrupted time, I realized it was time for me to address my hijacked attention span.

Stolen Focus is one of the most powerful books I’ve read about living in the modern world. I encourage all of you to buy a hardcopy and read it in full (and I stress the hardcopy part, as opposed to an ebook or audio. People understand and remember less of what they read on screens.) But given that time is currency and that people just don’t read much any more (over 50% of Americans didn’t read a single book in 2022), I’m featuring ten of what I believe to be the most important quotes from Johann’s work. I hope these ideas will get you thinking about the world you live in and encourage you to take control and make active changes in your life and the life of your children.

On the breakdown of democracy:

“Democracy requires the ability of a population to pay attentional long enough to identify real problems, distinguish them from fantasies, come up with solutions, and hold their leaders accountable if they fail to deliver them…people who can’t focus will be more drawn to simplistic authoritarian solutions—and less likely to see clearly when they fail.”

On why time seems to be speeding up:

“In 1986, if you added up all the information being blasted at the average human being—TV, radio, reading—it amounted to 40 newspapers’ worth of information every day. By 2007, they found it had risen to the equivalent of 174 newspapers per day. The increase in volume of information is what creates the sensation of the world speeding up.”

On why more information does not mean a better society:

Physicist Sune Lehmann, a professor in the Department of Applied Mathematics and Computer Science said of the increase in perceived speed, “ ‘What we are sacrificing is depth in all sorts of dimensions. If you have to keep up with everything and send emails all the time, there’s no time to reach depth. Depth connected to your work in relationships also takes time…all these things that require depth are suffering. It’s pulling us more and more up onto the surface.”

Adam Gazzaley, a professor of neurology, phsiology, and psychiatry at the Univeristy of California explained it this way: “Think of your brain as like a nightclub where, standing at the front of that club, there’s a bouncer. The bouncer’s job is to filter out most of the stimuli that are hitting you at any given moment—the traffic noise, the couple having an argument across the street, the cellphone ringing in the pocket of the person next to you—so that you can think coherently about one thing at a time. The bouncer is essential. This ability to filter out irrelevant information is crucial if you are going to be able to attend to your goals…In addition to switching tasks like never before, our brains are also being forced to filter more frantically than at any point in our past…The bouncer is overwhelmed, and the nightclub becomes full of rowdy assholes disrupting the normal dancing.”

On why you should really care about your ability to pay attention:

“Sune [Lehmann] had seen a photograph of Mark Zuckerberg, the founder of Facebook, standing in front of a room of people who were all reaching virtual reality headsets. He was the only person standing in actual reality, looking at them, smiling, pacing proudly around. When he saw it, Sune said, ‘I was like—holy shit, this is a metaphor for the future.’ If we don’t change course, he fears we are headed toward a world where ‘there’s going to be an upper class of people that are very aware’ of the risks to their attention and find ways to live within their limits, and then there will be the rest of society with ‘fewer resources to resist the manipulation, and they’re going to be living more and more inside their computers, being manipulated more and more.’ ”

On why you should engage in deliberately slow practices like yoga, tai chi, or meditation:

“If you go too fast, you overload your abilities and they degrade. But when you practice moving at a speed that is compatible with human nature—and you build that into your daily life—you begin to train your attention and focus. Slowness nurtures attention, and speed shatters it.”

On why multi-tasking is a myth that leads to creativity drain:

“When people think they’re doing several things at once, they’re actually “juggling” as Professor Earl Miller at the Massachusetts Institute of Technology explains. He continues, “ ‘They’re switching back and forth. They don’t notice the switching because the brain sort of papers it over, to give a seamless experience of consciousness…but if you spend a lot of this brain processing time switching and error correcting, you are simply giving your brain less opportunity to follow your associate links down to new places and really [have] truly original and creative thoughts.’ “

In short: “If you spend your time switching along, then the evidence suggests you’ll be slower, you’ll make more mistakes, you’ll be less creative, and you’ll remember less of what you do.”

On distracted driving:

The cognitive neuroscientist Dr. David Strayer at the University of Utah conducted detailed research where he got people to use driving simulators and tracked how safe their driving was when they were distracted by technology—something as simple as their phone receiving a text. It turned out their level of impairment was “very similar” to if they were drunk. The distraction all around us isn’t just annoying, it’s deadly: around one in five car accidents are now due to a distracted driver.”

On the manipulation of light and how it affects sleep:

“We evolved to get a rush of energy when the sun began to set. This was very helpful to our ancestors…[who] got a fresh rush of energy just as the light waned so they could safely get back to their tribe and finish the things they needed to do that day. But now we control the light. We decide when the sunset happens. So if we keep bright lights switched on right until the moment we decided to go to sleep, or we watch TV on our phones in bed, when we switch them off we accidentally trigger a physical process—our bodies think this budding waning of light is the arrival of sunset, so they release a rush of fresh energy to help you get back to your cave.”

On ADHD:

Johann spends a good chunk of the book exploring the ADHD topic, but in my opinion, it boils down to the following:

“To pay attention in normal ways, you need to feel safe. When children can’t pay attention, it’s often a signal that they are under terrible stress. If you’re medicating a child in that situation, you’re colluding with them remaining in a violent or unacceptable situation.”

On the hypocrisy of Big Tech:

Aza Raskin, former creative lead at Firefox, designed the now-ubiquitous “infinite scroll” that keeps content continuous on Instagram, Facebook, Twitter, etc. What started off as a way to make browsing more convenient has now been usurped by Big Tech to keep eyeballs on screens, because “the longer you make people look at their phones, the more advertising they see—and therefore the more money Google gets.”

Aza says, “one of the ironies is there are these incredibly popular workshops at Facebook and Google about mindfulness–about creating the mental space to make decisions nonreactively—and they are also the biggest perpetrators of non-mindfulness in the world.”

Chamath Palihapitiya, Facebook’s former Vice President of growth, explained in a speech that the effects [of Facebook] “are so negative that his kids ‘aren’t allowed to use that shit.’”

James Williams, former Google strategist, once “addressed an audience of hundreds of leading tech designers and asked them a simple question: ‘How many of you want to live in the world you are designing?’ There was a silence in the room. People looked around them. Nobody put up their hand.”

More articles from the blog

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February 13, 2025

On choosing thought: And not deciding failure in advance.

read the article

February 6, 2025

A Brief History of Psychiatric Diagnosis, Part II: The Diagnostic Statistical Manual of Mental Disorders (DSM) is Born.

read the article

January 30, 2025

A Brief History of Psychiatric Diagnosis, Part I: Eugenics, syphilis, and the pursuit of human perfection.

read the article

January 23, 2025

On knowing less: Creating conscious distance.

read the article

It’s been a frigid and snowy year winter in the Washoe Valley, and much of our infrastructure is being tested. Trees are down all over town, the weight of heavy snow too much for delicate branches. Reno’s signature neon lights are dim and patchy, presumably due to wiring shorts. My house lost power and cell service for three days over the New Year’s weekend, leaving the dog and me to head across town and huddle next to my mother’s fireplace.

I am struck by the obvious metaphor: it is in times of extreme events where cracks— disregarded for so long—become too big to ignore. It was only in the aftermath of the power outage that support from Oregon and Idaho was brought in, despite long-standing signs of a grid too fragile to handle a heavy winter.

The timing of these storms plus the entry into a new year has pushed me into a state of reflection and repair. The extreme personal events of 2022—the release of MAY CAUSE SIDE EFFECTS, the death of a friend, discovering a genetic mutation, and the slow, torturous separation from a long-term partner—didn’t just reveal cracks, it shorted the entire system and is now forcing me to rebuild.

At the center of this restructure is the question: What am I optimizing for?

Said another way: What kind of life do I want? How do my choices support or work against that goal?

For each answer that comes to mind, I look for the core value underneath. For example, a big goal is to never send out a resume or apply for a job ever again. This means my past work feeds the flywheel that creates future work. Practically, it means I need to keep producing so the flywheel has a steady stream of energy.

But the bigger question is why it’s so important for me to never again go through a formal job search, and that comes down to how I want to live my life. I value my independence and ability to be in charge of my own schedule above all else. If I’m going through a traditional application process, it means I’d be working for someone else, therefore giving up a core value to meet external expectations. It’s just not going to work for me.

Following this train of thought, I’ve come up with the following North Star: I am optimizing to create a life where I work as much as I want and earn as much as I need.

Simplifying the goal to a single sentence will, in theory, help me make choices that support this goal. A shiny opportunity with a lot of money may come along, but if I already have as much money as I need and the new job requires me to work more than I want, why would I go down a path that works against my core values?

More articles from the blog

see all articles

February 13, 2025

On choosing thought: And not deciding failure in advance.

read the article

February 6, 2025

A Brief History of Psychiatric Diagnosis, Part II: The Diagnostic Statistical Manual of Mental Disorders (DSM) is Born.

read the article

January 30, 2025

A Brief History of Psychiatric Diagnosis, Part I: Eugenics, syphilis, and the pursuit of human perfection.

read the article

January 23, 2025

On knowing less: Creating conscious distance.

read the article

In 2018, after thirty-two years of relishing in perfect eyesight, a routine optometry appointment indicated that it was time for me to get glasses. My first question was, “What about contacts?”

For as long as I can remember, I’ve had strong reactions to tactile sensations. Mostly, I don’t like it. I pull away from touch, get little nauseated around pockmarked surfaces, and am picky about fabrics. The wrong type of sweater doesn’t just make me itchy, it makes me irate.

When the glasses hammer came down, I hoped that contacts or laser eye surgery would keep me from having glasses touch my face. But my eyes don’t tolerate contacts well, and I’m not a candidate for LASIK or PRK (something about odd shaped corneas.) Bespectacled I became, begrudgingly.

It was all manageable enough until covid hit and masks became the norm. I’ve loathed those pieces of scratchy cloth from the moment they arrived, not because of their (bizarre) association with political peacocking and righteous indignation, but because of the fury that rises with in me from having so much stuff on my face. The masks could be made of silk and I’d still want to burn every one of them.

Of course, they aren’t always optional—at least not where I live. I’ve gone through dozens of styles of masks, desperate to find one that doesn’t make me want to jump out of my skin when I have to put it on. The ‘ole surgical standbys are the least rage-inducing, especially if they’re black or white. (The blue ones make everywhere feel like a hospital.)

Overall, it’s been frustrating to step into anger every time I go somewhere with a mask requirement. Because there’s so much emotion swirling around the pandemic in the first place, I always assumed the irritation that arrived was connected to spending the last two years living in what can only be described as a clusterfuck.

But a few weeks ago, in a startling example of delayed logic, I had an epiphany: take off the damn glasses. My eyesight is strong enough that I can make my way through the world without specs. I may not recognize you in a crowd 100 feet away, but I can still make out the fuzzy brands of crackers on a grocery store shelf. When I simply removed the glasses obstacle, my anger evaporated.

For two years I’ve been hearing people say, “I don’t even notice the mask anymore,” to which I resisted the urge to punch them in the face. Now, I leave my glasses in the car peruse retail stores in peace. It’s been a revelation, I tell you. Such a simple solution, too.

It’s not always the destructive choices that that contribute to melancholy or anger. Sometimes, it’s a basic assumption you’ve learned to take as truth. In my case, the assumption was that my glasses were an extension of my body, always on me unless I was sleeping or showering. Because of that benign assumption, it never occurred to me that taking them off might actually beneficial. As a result, I spent almost two years fighting daily anger over something I was in control of all along.

My challenge to you, and a journaling prompt for those of you so inclined: Examine your life and look for opportunities to take off the metaphorical glasses. How might this contribute to inner overall peace and happiness?

More articles from the blog

see all articles

February 13, 2025

On choosing thought: And not deciding failure in advance.

read the article

February 6, 2025

A Brief History of Psychiatric Diagnosis, Part II: The Diagnostic Statistical Manual of Mental Disorders (DSM) is Born.

read the article

January 30, 2025

A Brief History of Psychiatric Diagnosis, Part I: Eugenics, syphilis, and the pursuit of human perfection.

read the article

January 23, 2025

On knowing less: Creating conscious distance.

read the article

Thank you everyone for your support over the past few months. I’ve spent the time in monk-mode, putting the last serious edits into my memoir, MAY CAUSE SIDE EFFECTS (Central Recovery Press, June 2022).

The work paid off. Johann Hari, award-winning journalist and author of the international bestseller Lost Connections: Uncovering the Real Causes of Depression and Unexpected Solutionssaid my book is “a heart-rending and tender memoir that will start conversations we urgently need to have.” Lost Connections is arguably the best book on depression and depression recovery in the world, and I am honored to have Johann endorse my work.

MAY CAUSE SIDE EFFECTS is available for preorder. If you can, please consider ordering from your local independent bookstore. Not only does it support local business, but bestseller lists rank orders from independent bookstores higher than orders from Amazon.

Barnes & Nobles | Amazon | Indiebound | The Writer’s Block

Ask Brooke: Lessons on Grief

Because so many people reach out to me with questions about depression, antidepressants, and recovery, I decided to make those questions part of my blog repertoire.

If you would like to Ask Brooke a question, you can do so here.

Today’s question is from a reporter at HerCampus who asked:

What advice would you give to a young person about grief?

My father died when I was in high school, so I spent much of my college experience “grieving” his death. I say “grieving” because at that point, I was medicated up to my eyeballs on psychiatric drugs given to me to inhibit the grieving process. The decision to medicate me as a response to grief has had long term consequences on my life (it’s what my book is about), so this is a topic that sits deep in my heart.

There are two key aspects to processing grief, especially as a young person whose mind isn’t fully developed. The first, and arguably most important, is to understand that the response to grief is not necessarily aligned or timed with the trauma itself. 

Hours after my father died, I went to see the Rocky Horror Picture Show and laughed with my friends. The adults around me were perplexed, and I remember feeling like I “shouldn’t” be happy (cue the shame) even though I was happy to be there.

Now, as a 35-year old, I understand their confusion. But as a teenager, I didn’t get what it meant to lose a parent. It was kind of like the first day of calculus. I had a vague notion that it was going to be hard, but because I didn’t understand any of it on the first day of school, the looming difficulty didn’t mean anything to me. It took time for me to understand enough about calculus to even have the vocabulary to describe how difficult it was, just like it took months for me to show any sort of outward grief from losing my father. But by then, I’d been sent to a psychiatrist because I wasn’t “grieving properly.”

What actually happened was that I was in shock from the trauma and slow to release emotion. I wasn’t aware that trauma and emotion can be separated by weeks, months, or years, so everyone (including me) thought I was “doing okay.” When the emotion finally did come out, I blamed it on the circumstance at the time, thinking that because I’d been “doing okay” so far, my emotions were unrelated to grief.

This is tricky because grief is often mistaken for a psychiatric illness, which leads to misdiagnosis and overmedication. Over the years, the Diagnostic and Statistical Manual of Mental Disorders has changed its criteria for distinguishing between major depressive disorder and grief. The third edition of the DSM, which governed the psychiatric industry from 1980 to 1994, gave patients one year of bereavement leeway before they could officially be diagnosed with a mental disorder. The fourth edition of the DSM slashed the timeframe down to two months. And the DSM-V, published in 2013, eliminated it entirely. Rather, if you’re not “over” a in a few weeks, you can be officially diagnosed with a mental illness—an unconscionable change, in my opinion.

It’s also important for young people to understand that grieving includes joy. Grief is not necessarily a blanket of blurry darkness in which no levity can get through. It comes in waves, which means there are pockets of time to feel joy. Fully feeling that joy or happiness is just as important as feeling the loss. Joy reminds us that we are alive and that we have something to live for. It honors the person or experience that’s been lost.

Had I known that back when I went to the Rocky Horror Picture Show, I may not have stepped into the shame of experiencing joy during grief. I may not have learned to view the world through a nihilist, depressed lens. I may never have been medicated for a mental illness I don’t know if I ever really had.

What I know for sure is that when I got off all the antidepressants, after 15 years, the grief I’d medicated away for so long was still there. I had to process it, a decade and a half later, which was much more destructive than it would have been had I let it unfold naturally.

Grief will always wait for you. It can be delayed but not avoided. Embrace it when it comes. Process it. Know that by feeling it you are transforming it into light and love.


image of Fuckit Bucket™ products

Need a little giggle? Order one of my Fuckit Buckets™.

Look, we know that life is a special sort of disaster right now. Your closet is your office, the kids are still at home, and still your mother-law is calling you fat again. Let this little charm be a reminder that sometimes you have to chuck it in the Fuckit Bucket™ and move on!

Get your own Fuckit Bucket™

After 15 years of depression and antidepressants, my mission is to help people find hope in the name of healing. My memoir on the subject, MAY CAUSE SIDE EFFECTS, publishes on May 10, 2022. Pre-order it on Barnes & Nobles, Amazon, or wherever books are sold. For the most up-to-date announcements, subscribe to my newsletter HAPPINESS IS A SKILL.

More articles from the blog

see all articles

February 13, 2025

On choosing thought: And not deciding failure in advance.

read the article

February 6, 2025

A Brief History of Psychiatric Diagnosis, Part II: The Diagnostic Statistical Manual of Mental Disorders (DSM) is Born.

read the article

January 30, 2025

A Brief History of Psychiatric Diagnosis, Part I: Eugenics, syphilis, and the pursuit of human perfection.

read the article

January 23, 2025

On knowing less: Creating conscious distance.

read the article

One of the most underrated and useful techniques in creating a steady life is to understand the purpose of priority. And yet, like most things in our hustle harder society, “priority” is a word that only comes up around work. We instinctively know that when it comes to our job, there are certain things that are more important than others. We’re okay with letting busy work fall to the wayside when a deadline is looming, but when it comes to our personal life, prioritization is often replaced with the phrase, “I don’t have time.”

As in, “I don’t have time to work out” or “I don’t have time to cook” or “I don’t have time to write that novel.”

white puzzle and text overlay image for pinterest

This is, to be frank, bullshit. You do have time to work out. You do have time to cook. You do have time to write that novel. It’s just that none of this is your priority. You are not choosing to build these activities into your day, and therefore it doesn’t get done.

Whenever I point this out to people who complain about not getting around to one thing or another, I’m always shocked by how defensive they become. When it comes to things we “should” be doing, we have a nasty habit of defending our own choices in order to rationalize our lack of action. We let the excuses fly, as if not working out or not cooking is somehow an attack on our character.

But if we shift our mindset from “I don’t have time” to “it’s not my priority,” we relieve ourselves of the guilt that comes with not accomplishing a task. Working out simply isn’t a priority. Cooking is not a priority. Writing a novel is not a priority.

And it’s okay.

As long as you’re being honest with yourself about why you choose to spend your time the way you do, it doesn’t matter if you never step foot in a gym or put pen to paper.

This blog is my priority every Monday morning. Objectively, the few hours of dedicated writing are probably better spent on paid work, pitching editors, or trying to build a better following so my book gets bought. But, even though it won’t be winning a Pulitzer and I’m not influencing millions of people with my words, I like starting my week with a low-stakes task that keeps me writing and reflecting. And I know that if I don’t do it on Monday morning before I get bogged down with other jobs, it won’t get done. So I prioritize it first.

What frustration would melt away if you acknowledge that all the things you “don’t have time to do” are simply not your priority right now? How might your life be more enjoyable if you stop beating yourself up for everything you’re not doing? And what might happen if you shift your priorities toward what you really want?


image of Fuckit Bucket™ products

Need a little giggle? Order one of my Fuckit Buckets™.

Look, we know that life is a special sort of disaster right now. Your closet is your office, the kids are still at home, and still your mother-law is calling you fat again. Let this little charm be a reminder that sometimes you have to chuck it in the Fuckit Bucket™ and move on!

Get your own Fuckit Bucket™

After 15 years of depression and antidepressants, my mission is to help people find hope in the name of healing. My memoir on the subject, MAY CAUSE SIDE EFFECTS, publishes on May 10, 2022. Pre-order it on Barnes & Nobles, Amazon, or wherever books are sold. For the most up-to-date announcements, subscribe to my newsletter HAPPINESS IS A SKILL.


Coming September 6, 2022

May Cause Side Effects

Brooke’s memoir is now available for preorder wherever books are sold.

This is a heart-rending and tender memoir that will start conversations we urgently need to have. It’s moving and important.

Johann Hari, author of New York Times bestseller Chasing the Scream and international bestseller 
Lost Connections: Uncovering the Real Causes of Depression—and the Unexpected Solutions

More articles from the blog

see all articles

February 13, 2025

On choosing thought: And not deciding failure in advance.

read the article

February 6, 2025

A Brief History of Psychiatric Diagnosis, Part II: The Diagnostic Statistical Manual of Mental Disorders (DSM) is Born.

read the article

January 30, 2025

A Brief History of Psychiatric Diagnosis, Part I: Eugenics, syphilis, and the pursuit of human perfection.

read the article

January 23, 2025

On knowing less: Creating conscious distance.

read the article

“Everything can be taken from a man but one thing: the last of the human freedoms—to choose one’s attitude in any given set of circumstances, to choose one’s own way.” – Victor Frankl

In a recent interview with Tim Ferriss, author and business strategist Greg McKeown talked about a concept he called, “The Lighter Path.”

The Lighter Path, in essence, is the ability to cultivate a spirit of hope and ease even in the most difficult of times. Its antithesis is not the darker path, but the heavier path; the path that creates more chaos, more hurt, more work.

scale and text overlay image for pinterest

McKeown developed this idea after his bubbly, chatty 14-year-old daughter, Eve, began to turn morose and awkward. Her personality change was originally written off as typical teenage behavior, but after Eve failed a basic physical therapy test, she was taken to a neurologist. Despite a battery of inconclusive tests, her condition worsened to the point where Eve could no longer talk or write her own name.

brooke siem in the tulip field image with text overlay for pinterest

“Everything came back negative, sort of good news, but bad news because you’d have no idea what’s going on,” McKeown said. “And she is fully on the way to becoming comatose and then dying in a coma…this is the stuff that agony is made of, right?”

McKeown realized that despite his daughter’s grim condition, he had two choices: he could take the lighter path and make this already awful situation easier on himself and his family, or, he could take the heavier path and make it more even more difficult.

In a crisis or as a response to trauma, the heavier path is tempting and easy to fall into. It starts with complaining or trying to solve the problem through sheer effort. Focusing all that energy on one person or problem can take the air out of the room for everyone else, leading to destroyed marriages and families.

“All of these things weren’t just hypothetical,” McKeown said. “They were right there. There was that opportunity.”

The lighter path, though, creates a space of trust and hope. While it “doesn’t feel super light,” it is lighter than the heavier path. And in times of crisis, we need all the help we can get.

McKeown said, “We would get around the piano and we would sing. We would read together at night. We would do the small and simple and even enjoyable things. And so, what was at times agonizing, but could have been seriously worse, even, was actually punctuated with joy.”

Despite never getting a formal diagnosis, Eve McKeown fully recovered. Though her story creates a poignant container to explore the idea behind light and heavy paths, it’s important to note that we don’t need a crisis to choose the lighter path.

Take a moment and think about the topography of your life. Are there any burdens, grudges, or transgressions you haven’t forgiven? Are you in a constant state of anger and defensiveness over the injustices of the world? Is there clutter, literal or figurative, that simply makes life harder?

All of this leads to a life lived on the heavier path. To become aware of the heaviness and to consciously choose to rewrite the stories around this heaviness—that is the work. That is your job. And it isn’t all or nothing. Removing even 20% of your psychic drag could have a huge impact on your life.

Start small. Maybe it’s saying “no” to a draining project, smoothing things out with an old friend who voted for the other guy, or pausing before you write a knee-jerk text message that’s sure to cause more chaos.

Simply ask yourself, before you make a choice, “Does this have to be difficult?”


image of Fuckit Bucket™ products

Need a little giggle? Order one of my Fuckit Buckets™.

Look, we know that life is a special sort of disaster right now. Your closet is your office, the kids are still at home, and still your mother-law is calling you fat again. Let this little charm be a reminder that sometimes you have to chuck it in the Fuckit Bucket™ and move on!

Get your own Fuckit Bucket™

After 15 years of depression and antidepressants, my mission is to help people find hope in the name of healing. My memoir on the subject, MAY CAUSE SIDE EFFECTS, publishes on May 10, 2022. Pre-order it on Barnes & Nobles, Amazon, or wherever books are sold. For the most up-to-date announcements, subscribe to my newsletter HAPPINESS IS A SKILL.


Coming September 6, 2022

May Cause Side Effects

Brooke’s memoir is now available for preorder wherever books are sold.

This is a heart-rending and tender memoir that will start conversations we urgently need to have. It’s moving and important.

Johann Hari, author of New York Times bestseller Chasing the Scream and international bestseller 
Lost Connections: Uncovering the Real Causes of Depression—and the Unexpected Solutions

More articles from the blog

see all articles

February 13, 2025

On choosing thought: And not deciding failure in advance.

read the article

February 6, 2025

A Brief History of Psychiatric Diagnosis, Part II: The Diagnostic Statistical Manual of Mental Disorders (DSM) is Born.

read the article

January 30, 2025

A Brief History of Psychiatric Diagnosis, Part I: Eugenics, syphilis, and the pursuit of human perfection.

read the article

January 23, 2025

On knowing less: Creating conscious distance.

read the article

During my decade and a half of deep depression, my mother often said to me, “Honey, you can choose not to be depressed.”

To which I responded, seething, “Depression isn’t a choice. Why would I choose this? I can’t just turn it on and off.”

And then I’d huff out of the room and stew in twisted satisfaction, my depression a badge of honor. I didn’t believe that depression was a choice, but I did believe that enduring my depression made me stronger than everyone who wasn’t persisting through darkness.

blue orange image with full text overlay

Today, I cringe at my own response. Here was a woman who, after being widowed at 47, survived breast cancer, underwent open-heart surgery, kept a business with 40 employees afloat during the recession, and did it all while raising an only child who spent those years huffing out of the room. My mother had every reason to fall into a hole of depression, and yet she never succumbed. That’s real strength. Some people might look at the difference between my mother and me as a difference in “brain chemistry.” Rather, one of us was “wired” to go off the depression deep end while the other was not.

I don’t buy it. Not only because the chemical imbalance theory has been debunked over and over and over and over and over again, but because in looking at how my mother and I processed the traumas of our individual lives, she chose to exercise the muscle of it-can-happen-to-anyone resilience while I exercised the muscle of moral elitism. Rather, I repeatedly chose to feed my inherent belief that I was special and therefore, tragic.

Part of this was age. I was 15 when my father died, arguably the most self-involved age in existence. And while I’d love to say that my lugubrious swim in the seas of melancholy was unconscious, the reality is that I knew exactly what I was doing. I liked the pity. I liked the attention. I liked the freedom of loss. No one expects much of the grieving, and I was happy to be left alone.

Had I shed this narrative once I graduated high school, perhaps I could have started to build the muscle of resilience. Instead, I doubled down on moral elitism, working that muscle from all angles until I was left with nothing but suicidal thoughts. It was never a choice to To Be or Not To Be Depressed, but the culmination of fifteen years of small choices that atrophied my resilience.

That is the choice my mother was talking about all those years ago. Depression is a beast that rips the reigns from your hands and drags you along for the ride. But it ebbs and flows, leaving pockets of opportunity where it’s up to you to find the strength to pick up those reigns and right yourself back on course.

No, there isn’t an on-off switch. But there is the single choice to commit to making thousands of little choices, building more and more resilience and awareness. Like a muscle, it gets stronger over time. And just like building muscle, it starts slow. One little choice. One little change. One little life.


image of Fuckit Bucket™ products

Need a little giggle? Order one of my Fuckit Buckets™.

Look, we know that life is a special sort of disaster right now. Your closet is your office, the kids are still at home, and still your mother-law is calling you fat again. Let this little charm be a reminder that sometimes you have to chuck it in the Fuckit Bucket™ and move on!

Get your own Fuckit Bucket™

After 15 years of depression and antidepressants, my mission is to help people find hope in the name of healing. My memoir on the subject, MAY CAUSE SIDE EFFECTS, publishes on May 10, 2022. Pre-order it on Barnes & Nobles, Amazon, or wherever books are sold. For the most up-to-date announcements, subscribe to my newsletter HAPPINESS IS A SKILL.


Coming September 6, 2022

May Cause Side Effects

Brooke’s memoir is now available for preorder wherever books are sold.

This is a heart-rending and tender memoir that will start conversations we urgently need to have. It’s moving and important.

Johann Hari, author of New York Times bestseller Chasing the Scream and international bestseller 
Lost Connections: Uncovering the Real Causes of Depression—and the Unexpected Solutions

More articles from the blog

see all articles

February 13, 2025

On choosing thought: And not deciding failure in advance.

read the article

February 6, 2025

A Brief History of Psychiatric Diagnosis, Part II: The Diagnostic Statistical Manual of Mental Disorders (DSM) is Born.

read the article

January 30, 2025

A Brief History of Psychiatric Diagnosis, Part I: Eugenics, syphilis, and the pursuit of human perfection.

read the article

January 23, 2025

On knowing less: Creating conscious distance.

read the article

This is the last installment of Debunking the Chemical Imbalance Theory of Depression.
The previous installments can be found here: Part I | Part II | Part III | Part IV


With social media at the forefront of 21st-century communication, there is a tendency for non-experts to argue with one another via evidence-based research. Having an opinion is dangerous when a single Tweet can get you fired, but making a statement that begins, “Studies show that…” cushions whatever belief follows.

scale and text overlay image for pinterest

But research is rigged from the start. It’s an open secret in the academic community, but little known by the rest of us. There are predatory journals that profit off of bad science or outright fiction, but because the journals and websites look official, people confuse them for legitimate science. There’s also the fact that Big Pharma funds its own trials (that are used as the basis for FDA approval) which creates an obvious conflict of interest. And don’t forget about medical ghostwriting, where pharmaceutical reps actually write the content of published articles but slap a (paid) doctor’s name on it. Then there’s the replication crisis, in which the results of research can’t be replicated, which indicates that the results are likely false.

Of course, there’s also all the legitimate, ethical research that does exist but has to survive within the chaos. Can you tell the difference? Are you sure about that? And if you can spot the good from the bad, what about all the research that was never published in the first place? Is a lie by omission still a lie?

This question is at the heart of publication bias, arguably the most troubling aspect of the current state of drug research. Publication bias is what happens when the outcome of a study determines whether or not it gets published or distributed. For example, a researcher could conduct 10 studies claiming that a new drug lowers blood pressure. Let’s say that in four of the trials, blood pressure levels didn’t change. In four other trials, blood pressure levels actually increased. But in two trials, blood pressure levels decreased.

Though 8 of 10 trials did not have the intended outcome, there is nothing in the bylaws that state that the researchers have to publicize that information. Instead, they can focus their publication efforts on the two trials that did show a positive reduction in blood pressure and use those results to get their drug approved by the FDA—even though their own research showed that the drug flopped 80% of the time.

This graveyard of failed or abandoned studies means that doctors don’t have complete information for the drugs they’re prescribing. This is a big reason why I don’t like it when people lump all doctors in a box when it comes to prescribed harm. They can do their research and think that they are acting in an ethical way, but they are being misled just like the rest of us.

How bad is it? Let’s take a look.

In 2015, researcher Erick. H Turner used the Freedom of Information Act to gather all the trials on antidepressants that were approved by the FDA over a 15-year period. Keep in mind that this isn’t all the trials ever conducted, just the ones used to get marketing authorization. Any unsubmitted trials, whether failed or abandoned, are known only to the researchers. Only the results of trials submitted to the FDA are available through the Freedom of Information Act.

There were 74 trials submitted to the FDA; 38 showed that the antidepressants had a positive effect (compared to a placebo and/or a competitor), and 36 showed either no effect or a negative effect. Essentially, it’s a coin toss.

Turner then cross-referenced these studies with peer-reviewed journals to see which ones were actually published for public consumption. Of the 74 original trials, 37 of the positive studies were published whereas only 3 of the negative trials were published.

Rather, from the FDA’s perspective, these drugs had some sort of positive impact 51% of the time. From the public’s perspective, if we’re basing this off of research doctors and patients can access, these drugs are effective 92.5% of the time.

In the words of Ben Goldacre, Senior Clinical Research Fellow at the Centre for Evidence-Based Medicine at the University of Oxford, “If I tossed a coin a hundred times, and I’m allowed to withhold from you the answers half the time, then I can convince you that I have a coin with two heads.”

And that’s why pharmaceutical companies to legally allowed to advertise that antidepressants like Pristiq are “proven to treat depression” and “thought to work by affecting the levels of two chemicals in the brain, serotonin and norepinephrine.” It doesn’t matter that we know it’s not the whole story, because manufacturers aren’t forced to report all their trials.

Unfortunately, there’s no real answer to any of this. Doing your own research is fabulous, but know that the research is incomplete. At some point, you have to reach inside yourself and calibrate your own inner compass.


image of Fuckit Bucket™ products

Need a little giggle? Order one of my Fuckit Buckets™.

Look, we know that life is a special sort of disaster right now. Your closet is your office, the kids are still at home, and still your mother-law is calling you fat again. Let this little charm be a reminder that sometimes you have to chuck it in the Fuckit Bucket™ and move on!

Get your own Fuckit Bucket™

After 15 years of depression and antidepressants, my mission is to help people find hope in the name of healing. My memoir on the subject, MAY CAUSE SIDE EFFECTS, publishes on May 10, 2022. Pre-order it on Barnes & Nobles, Amazon, or wherever books are sold. For the most up-to-date announcements, subscribe to my newsletter HAPPINESS IS A SKILL.


Coming September 6, 2022

May Cause Side Effects

Brooke’s memoir is now available for preorder wherever books are sold.

This is a heart-rending and tender memoir that will start conversations we urgently need to have. It’s moving and important.

Johann Hari, author of New York Times bestseller Chasing the Scream and international bestseller 
Lost Connections: Uncovering the Real Causes of Depression—and the Unexpected Solutions

More articles from the blog

see all articles

February 13, 2025

On choosing thought: And not deciding failure in advance.

read the article

February 6, 2025

A Brief History of Psychiatric Diagnosis, Part II: The Diagnostic Statistical Manual of Mental Disorders (DSM) is Born.

read the article

January 30, 2025

A Brief History of Psychiatric Diagnosis, Part I: Eugenics, syphilis, and the pursuit of human perfection.

read the article

January 23, 2025

On knowing less: Creating conscious distance.

read the article

Part I—The History of Chemical Imbalance Theory
Part II—The Flaws of Chemical Imbalance Theory
Part III—Pharmaceutical Advertising & Chemical Imbalance Theory


At this point in our journey, you’re probably coming around to the idea that the chemical imbalance theory is flawed at best and an outright lie at worst. Although it’s been disproven over and over again and that patients who think a chemical imbalance is the cause of their depression actually have worse treatment outcomes, pharmaceutical advertisements and lifestyle and health websites continue to push the narrative.

Why?

The chemical imbalance theory is unique in that it scratches a specific itch for pharmaceutical companies, doctors, and patients. Pharmaceutical companies need the chemical imbalance theory to peddle their product. They can’t manufacture a pill to erase the lingering, emotional effects of childhood trauma or an unfulfilling life, but they can produce a “biological answer” to a “biological problem.” Someone prone to blood clots takes an anticoagulant. Someone prone to depression takes an antidepressant. The language lends itself to storytelling; the patient a damsel in distress, the drug a regal prince.

This myth wouldn’t survive, however, if people weren’t buying it. It’s easy to understand why people flock to the pharmacy. When people are in pain, they need help. Immediately. Unraveling the emotional ball of knotted yarn is a long and messy process made longer and messier by a bungled healthcare system, a cultural inability to tolerate discomfort, and a social system that doesn’t support people through drastic life changes. A $30 bottle of generic venlafaxine and the assumption that it’s all gone wrong thanks to a chemical imbalance is much easier to swallow.

man shouting into a speaking tube and text overlay

Besides, patients aren’t supposed to be the expert. They aren’t following the words of Dr. Thomas Insel, former Director of the National Institute of Mental Health, who explicitly stated in a 2007 Newsweek article that “a depressed brain is not necessarily underproducing [neurotransmitters.]” Instead, people are influenced by media (advertisements) and experts (doctors.) When both of these institutions are steering them towards a chemical “solution,” why shouldn’t they follow the advice? After all, isn’t “asking your doctor” the right thing to do?

But why are doctors, the experts who are supposed to rely on science, so willing to indulge the chemical imbalance myth when overwhelming, decades-long research does not support it?

The knee-jerk reaction is, of course, money baby! Though the days of outright paying doctors to prescribe specific, brand-name medications are long gone, physicians still receive kickbacks from pharmaceutical companies. It’s even considered public information and can be viewed on OpenPaymentsData.CMS.com. But with the plethora of generic psychiatric drugs available (and that the average per-physician payout, in 2015, was only $201), I don’t think money is the driving factor for psychiatric drug prescription.

A more robust hypothesis is that the chemical imbalance theory has helped destigmatize mental illness, enabling patients to “come out of the closet” with their depression. In theory, if people aren’t afraid to speak up about their private struggles, they are more likely to seek help. This hypothesis is further bolstered by the fact that insurance companies require a diagnosis before they will pay for treatment claims. Treatment for a “bag marriage” or “childhood sexual abuse” is not covered. But treatment for Generalized Anxiety Disorder or Major Depressive Disorder is fair game.

To be labeled with a psychiatric disorder implies that something abnormal has gone wrong in the body and that returning to a state of “normal” is the reasonable thing to do. The chemical imbalance theory fits this narrative and creates a simple way for doctors to explain a complex problem under the time and financial constraints dictated by health insurance. The line between truth and fantasy might be blurred, but if the patient is getting help, does it matter?

Given the 30% rise in suicide rates from 2000 to 20016 despite a 400% increase in antidepressant use and an overall decrease in mental health stigma, I’m going to say that yes, that line between truth and fantasy does matter.

But the blame can’t fall fully on the prescriber’s shoulders. Even the most well-read and researched of the bunch can only operate on the information they’re able to find.

And as it turns out, the game is rigged from the start.

Next week, we’ll dive into publication bias. Or rather, how the pharmaceutical industry legally sells you a two-headed coin.


image of Fuckit Bucket™ products

Need a little giggle? Order one of my Fuckit Buckets™.

Look, we know that life is a special sort of disaster right now. Your closet is your office, the kids are still at home, and still your mother-law is calling you fat again. Let this little charm be a reminder that sometimes you have to chuck it in the Fuckit Bucket™ and move on!

Get your own Fuckit Bucket™

After 15 years of depression and antidepressants, my mission is to help people find hope in the name of healing. My memoir on the subject, MAY CAUSE SIDE EFFECTS, publishes on May 10, 2022. Pre-order it on Barnes & Nobles, Amazon, or wherever books are sold. For the most up-to-date announcements, subscribe to my newsletter HAPPINESS IS A SKILL.


Coming September 6, 2022

May Cause Side Effects

Brooke’s memoir is now available for preorder wherever books are sold.

This is a heart-rending and tender memoir that will start conversations we urgently need to have. It’s moving and important.

Johann Hari, author of New York Times bestseller Chasing the Scream and international bestseller 
Lost Connections: Uncovering the Real Causes of Depression—and the Unexpected Solutions

More articles from the blog

see all articles

February 13, 2025

On choosing thought: And not deciding failure in advance.

read the article

February 6, 2025

A Brief History of Psychiatric Diagnosis, Part II: The Diagnostic Statistical Manual of Mental Disorders (DSM) is Born.

read the article

January 30, 2025

A Brief History of Psychiatric Diagnosis, Part I: Eugenics, syphilis, and the pursuit of human perfection.

read the article

January 23, 2025

On knowing less: Creating conscious distance.

read the article

This is the third installment of an ongoing series debunking the chemical imbalance theory of depression. Part I examines the history of the theory while Part II examines its fatal flaws. Part III looks at the history of pharmaceutical advertising.

Antidepressants are a $26.25 billion dollar industry. If the industry as a whole was a person, it would be the 66th wealthiest individual on the planet. Zoloft, Lexapro, Xanax, Wellbutrin, Celexa, Prozac, Klonopin, Effexor, and Cymbalta all crack the top 50 most prescribed drugs in the United States, with Zoloft taking the 14th spot.

Pharmaceutical companies are also publicly traded, which means they’re incentivized to maximize profits for shareholders. And how do companies make more money? By increasing sales. And how do companies increase sales? Through advertising.

Medicine and prescription drugs are no exception. Prescription drugs, in this country, are a business. Full stop. The United States is one of only two countries in the world (New Zealand is the other) that allows direct-to-consumer (DTC) advertisement of pharmaceutical drugs. We simply cannot examine the rise of antidepressant use and the push behind the chemical imbalance theory without considering profit. As the saying goes, if you want the truth, follow the money.

pinterest image with blue pills and text overlay

At the turn of the 20th century, medications were classified either as “ethical drugs” listed by the American Medical Association (AMA) or “patent medications” that were mostly water with a little bit of alcohol, opium, or other mysterious ingredients thrown in. These patent medications were allowed to be advertised without regulation (and were therefore filled with false claims), yet they accounted for nearly half of newspaper revenue in the early 1900s.

In 1914 that The Federal Trade Commission (FTC) was created to crack down on false advertisements. Strangely, drug ads in medical journals were exempt from regulation. It wasn’t until 1938, after 105 people died from a drug that included antifreeze, that the FDA ruled that drugs have to be proven safe before marketing. But they also put the burden of determining whether or not the drug was safe on the drug manufacturer, rather than a third party.

It wasn’t until 1969, a few years after 10,000 babies were born with birth defects as a direct result of thalidomide poisoning from a drug used to treat morning sickness in pregnant women, that the FDA began to require that manufacturers provide information on side effects, contraindications, and effectiveness in drug advertisements. At the time, the majority of drug ads were in medical journals or aimed at physicians. DTC advertising only began in the late 70s and early 80s, when pharmaceutical companies cut out the middle man and began aiming advertisements directly at consumers.

Though there was a brief moratorium on DTC advertising in 1983 after a well-advertised arthritis drug made by Eli Lilly was pulled off the market due to adverse drug effects, the FDA declared in 1985 that drugs could be advertised directly to consumers as long as they met the same criteria as drugs advertised to physicians. All those side effects, contraindications, and risks needed to be included in the DTC ad. This declaration made it difficult to advertise on TV and radio because verbally listing all the side effects simply took up too much air time, so advertising shifted to print media, where disclaimers in small print could flourish.

The 1990s ushered in the advertising era of “lifestyle” drugs for everything from erectile dysfunction to baldness to, you guessed it, depression. In 1997, with pressure from the pharmaceutical industry, the FDA drafted official television-friendly guidelines for drug advertisements (cue the speedy, may-cause-side-effects voiceover.) In the year after these regulations were drafted, DTC drug advertisement spending doubled from $1.1 billion in 1998 to $2.24 billion in 1999. By 2000, every $1 spent in drug advertising resulted in $4.20 in retail drug sales.

In 2015, the American Medical Association called for a complete ban on DTC drug advertisement due to anti-competitive behavior that allowed drug companies to manipulate drug prices for profit and then advertise the benefits of their inflated drugs to consumers. But the push to end DTC advertisements was shot down thanks to powerful drug lobbyists claiming that DTC advertisements provide patients with valuable information about their health and treatment options. By 2017, 72% of commercial breaks during the CBS Evening News contained drug ads.

In the next installment, I’ll examine how the advertising market has enabled pharmaceutical companies to prey on consumers by relying on the chemical imbalance theory as an easy explanation for depression.


image of Fuckit Bucket™ products

Need a little giggle? Order one of my Fuckit Buckets™.

Look, we know that life is a special sort of disaster right now. Your closet is your office, the kids are still at home, and still your mother-law is calling you fat again. Let this little charm be a reminder that sometimes you have to chuck it in the Fuckit Bucket™ and move on!

Get your own Fuckit Bucket™

After 15 years of depression and antidepressants, my mission is to help people find hope in the name of healing. My memoir on the subject, MAY CAUSE SIDE EFFECTS, publishes on May 10, 2022. Pre-order it on Barnes & Nobles, Amazon, or wherever books are sold. For the most up-to-date announcements, subscribe to my newsletter HAPPINESS IS A SKILL.


Coming September 6, 2022

May Cause Side Effects

Brooke’s memoir is now available for preorder wherever books are sold.

This is a heart-rending and tender memoir that will start conversations we urgently need to have. It’s moving and important.

Johann Hari, author of New York Times bestseller Chasing the Scream and international bestseller 
Lost Connections: Uncovering the Real Causes of Depression—and the Unexpected Solutions

More articles from the blog

see all articles

February 13, 2025

On choosing thought: And not deciding failure in advance.

read the article

February 6, 2025

A Brief History of Psychiatric Diagnosis, Part II: The Diagnostic Statistical Manual of Mental Disorders (DSM) is Born.

read the article

January 30, 2025

A Brief History of Psychiatric Diagnosis, Part I: Eugenics, syphilis, and the pursuit of human perfection.

read the article

January 23, 2025

On knowing less: Creating conscious distance.

read the article

This is Part II of Debunking the Chemical Imbalance theory. Part I can be found here.

Psychiatry, like most hard sciences, suffers as research trickle down from laboratories to the mainstream. Take our friend from Part I, Harvard neuropsychopharmacologist Joseph Schildkraut, who said in 1965 that the chemical imbalance theory was “at best a reductionistic oversimplification of a very complex biological state.”

pinterest image with text overlay

Though Schildkraut explicitly stated that there was no evidence to support or disprove the theory—which led to a generation of research that could not find a statistically notable link between biology and mental disorders—Schildkraut’s research was still cherry-picked by a verywellmind journalist for a January 2021 article entitled, “The Chemistry of Depression: What is the Biochemical Basis of Depression?”

The article gives the reader a general overview of how neurotransmitters work, the three neurotransmitters usually associated with depression (dopamine, norepinephrine, and serotonin), and the all familiar assumption that low levels of these chemicals may be associated with depression.

There are so many problems with this article that it would be impossible for me to unpack it all in one issue, so I’m going to focus on the most egregious statement and go from there: “Restoring the balance of brain chemicals could help alleviate symptoms—which is where the different classes of antidepressant medications may come in.”

For the sake of argument, let’s assume that an imbalance of “brain chemicals” is the cause of depression. How do we measure that imbalance in order to determine the amount and kind of antidepressants needed to restore the balance?

*crickets*

There is not, and never has been, a single test to measure the real-time amount of an individual’s “brain chemicals.” You cannot measure neurotransmitters in a blood test. You cannot measure neurotransmitters in an MRI or CT Scan. You can get an estimate of neurotransmitter levels by measuring something called biogenic amines in urine and spinal fluid. This test operates under the assumption that the results are an accurate depiction of what’s going on in the brain in real-time. This is a shaky assumption given that neurotransmitter levels literally change by the second and that up to 95% of serotonin is produced in the intestines.

There is also some research surrounding measuring neurotransmitter levels through PET scans, but like the biogenic amine test, it is at best, a snapshot in time that will never be relevant for 99.9% of patients.

If we don’t have any way to accurately measure neurotransmitter levels, then it stands to reason that we can’t know what is considered “balanced” in the first place, which is why the administration of psychiatric drugs is more of a guess than a science.

Knowing all this, a slew of questions emerge. If low levels of “brain chemicals” are responsible for depression, why is it that a drug filled with synthetic neurotransmitters can take more than a month to have an effect? And, if chemicals are the primary culprit, why do antidepressants only work for about 60% of patients? (Not to mention the fact that in the long run, talk therapy works as well as drug therapy, without the nasty side effects.)

Some people will argue that from a practical point of view, the validity of the chemical imbalance theory is irrelevant if the drugs help people. This argument would sit better with me if 1) pharmaceutical companies weren’t allowed to manipulate patients with misinformation based on a bunk theory. 2) Mainstream health websites like verywellmind didn’t continue to effectively mansplain the chemical cause of depression in exchange for website traffic. 3) If practitioners enforced short-term use of these drugs and 4) if practitioners actually knew how to take patients off these drugs safely and effectively.

But since none of those things are true, patients end up on a hamster wheel of drug-dependent diagnosis, spending their lives believing that their mental anguish is caused by a chemical imbalance that relieves them of actually addressing the problems and traumas in their lives that lead to depression.

In Part III, I’ll specifically focus on how pharmaceutical companies create billions of dollars in revenue by exploiting the chemical imbalance theory in order to market antidepressants to the general public.


image of Fuckit Bucket™ products

Need a little giggle? Order one of my Fuckit Buckets™.

Look, we know that life is a special sort of disaster right now. Your closet is your office, the kids are still at home, and still your mother-law is calling you fat again. Let this little charm be a reminder that sometimes you have to chuck it in the Fuckit Bucket™ and move on!

Get your own Fuckit Bucket™

After 15 years of depression and antidepressants, my mission is to help people find hope in the name of healing. My memoir on the subject, MAY CAUSE SIDE EFFECTS, publishes on May 10, 2022. Pre-order it on Barnes & Nobles, Amazon, or wherever books are sold. For the most up-to-date announcements, subscribe to my newsletter HAPPINESS IS A SKILL.


Coming September 6, 2022

May Cause Side Effects

Brooke’s memoir is now available for preorder wherever books are sold.

This is a heart-rending and tender memoir that will start conversations we urgently need to have. It’s moving and important.

Johann Hari, author of New York Times bestseller Chasing the Scream and international bestseller 
Lost Connections: Uncovering the Real Causes of Depression—and the Unexpected Solutions

More articles from the blog

see all articles

February 13, 2025

On choosing thought: And not deciding failure in advance.

read the article

February 6, 2025

A Brief History of Psychiatric Diagnosis, Part II: The Diagnostic Statistical Manual of Mental Disorders (DSM) is Born.

read the article

January 30, 2025

A Brief History of Psychiatric Diagnosis, Part I: Eugenics, syphilis, and the pursuit of human perfection.

read the article

January 23, 2025

On knowing less: Creating conscious distance.

read the article

I’m going to take the time to dive into the chemical imbalance theory of depression, and why it’s a big ‘o pile of crap. I’m taking the time to do this because 80% of people believe that depression is caused by a chemical imbalance, despite overwhelming evidence otherwise. Today I will focus on the history and discovery of antidepressants and the chemical imbalance theory.

The first antidepressant was discovered by accident.

In 1952, a drug designed to treat tuberculosis, iproniazid, had a surprising side effect: patients in the sanatorium became euphoric when treated with this drug.

Researchers experimented with the mood-altering effects of iproniazid for five years, ultimately discovering that it worked by inhibiting the monoamine oxidase (MAOI) enzyme, which breaks down serotonin and dopamine—two of the neurotransmitters involved in pleasurable emotions. But in 1957, after treating 400,000 depressed patients with the drug, researchers noticed that when patients ate cheese, chocolate, or alcohol, their blood pressure skyrocketed to dangerous levels. As it turns out, iproniazid didn’t just affect serotonin and dopamine, but norepinephrine as well. A release of norepinephrine constricts blood vessels, which leads to elevated blood pressure. Known as “the cheese reaction,” the use of iproniazid was quickly stopped.

But around the same time, researchers were studying a plant known as Rauwolfia serpentina, which had been used medicinally in India for everything from calming babies to insomnia to high blood pressure. Chemists extracted the active compound, called it reserpine, and began testing it on animals.

text overlay image for pinterest

Resperine was found to lower serotonin, norepinephrine, and dopamine, all of which lead to a period of near-catatonic inactivity in the animals. It was concluded that low serotonin, norepinephrine, and dopamine levels create a depressed state, and the “chemical imbalance theory” was born.

But there’s a catch: First, resperine was also used as an antipsychotic (rather, a tranquilizer) for schizophrenia and Huntington’s disease. Despite high doses and long-term use, only 6% percent of patients developed clinical depression, and all 6% had a history of depression to begin with. Bafflingly, in 1955, resperine was also the first compound shown to be an effective antidepressant, despite actually reducing levels of serotonin, norepinephrine, and dopamine.

Still, the discovery of iproniazid and resperine gave rise to the theory that different chemicals in the brain create different states of mind. Researchers and patients, it seemed, desperately wanted it to be true. Who wouldn’t want to distill their melancholy into a neat little bow that can be explained by a simple unbalance of a handful of chemicals?

But as early as 1965, the American Journal of Psychiatry put out a paper by Harvard neuropsychopharmacologist Joseph Schildkraut, who said the chemical imbalance theory was “at best a reductionistic oversimplification of a very complex biological state” and that there was no evidence to support or disprove the theory.

Schildkraut’s declaration inspired a generation of researchers to prove him wrong. But over and over again, they failed to find the link between statistically different levels of neurotransmitters between depressed patients and happy ones.

As the Council for Evidence-Based Psychiatry says, “Although scientists have been testing the chemical imbalance theory’s validity for over 40 years–and despite literally thousands of studies–there is still not one piece of direct evidence proving the theory correct. The chemical imbalance theory, in relation to any mental health disorder is thus unsubstantiated, yet a societal belief in chemical imbalances, largely owing to effective pharmaceutical marketing, remains prevalent today.”

In next blog post, I’ll explore the fatal flaws of the chemical imbalance theory, followed by the influence marketing has had on keeping this myth alive. Meanwhile, I’m keeping the links light today. There’s plenty to dig through in the issue itself.

Need a little giggle? Order one of my Fuckit Buckets™.

three images of the fuckit bucket collection

After 15 years of depression and antidepressants, my mission is to help people find hope in the name of healing. My memoir on the subject, MAY CAUSE SIDE EFFECTS, publishes on May 10, 2022. Pre-order it on Barnes & Nobles, Amazon, or wherever books are sold. For the most up-to-date announcements, subscribe to my newsletter HAPPINESS IS A SKILL.

Coming September 6, 2022

May Cause Side Effects

Brooke’s memoir is now available for preorder wherever books are sold.

This is a heart-rending and tender memoir that will start conversations we urgently need to have. It’s moving and important.

Johann Hari, author of New York Times bestseller Chasing the Scream and international bestseller 
Lost Connections: Uncovering the Real Causes of Depression—and the Unexpected Solutions

More articles from the blog

see all articles

February 13, 2025

On choosing thought: And not deciding failure in advance.

read the article

February 6, 2025

A Brief History of Psychiatric Diagnosis, Part II: The Diagnostic Statistical Manual of Mental Disorders (DSM) is Born.

read the article

January 30, 2025

A Brief History of Psychiatric Diagnosis, Part I: Eugenics, syphilis, and the pursuit of human perfection.

read the article

January 23, 2025

On knowing less: Creating conscious distance.

read the article